Individual
STACY BEARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 MARYLAND AVE, MCCOMB, MS 39648-3926
(601) 250-4815
Mailing address
886 NEW PROSPECT RD, DUBACH, LA 71235-3117
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3978
LA
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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